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Peter Magnusson1, Jonny Nordström2, Mark Lubberink3

  • 1Uppsala Universitet - Centrum för forskning och utveckling, Uppsala, Sweden, Region Gävleborg, Gävle Sweden Uppsala Universitet - Centrum för forskning och utveckling, Uppsala, Sweden Region Gävleborg, Gävle Sweden.

Lakartidningen
|July 24, 2019
PubMed
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Troponin elevation indicates myocardial infarction. Positron emission tomography (PET) using 15O-water tracer effectively diagnosed myocardial ischemia missed by scintigraphy, revealing microvascular dysfunction.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Elevated troponin levels suggest myocardial infarction, necessitating investigation into underlying causes for tailored treatment and prognosis.
  • Myocardial damage in patients with non-obstructive coronary arteries requires advanced diagnostic approaches like magnetic resonance tomography.

Observation:

  • A case presented with significant myocardial ischemia that was not detected by conventional myocardial scintigraphy.
  • This ischemia was, however, successfully identified using positron emission tomography (PET).

Findings:

  • The study highlights the diagnostic capability of 15O-water PET for quantitative assessment of myocardial perfusion.
  • PET imaging revealed regional abnormalities indicative of microvascular dysfunction, which were previously undetected.

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Implications:

  • Positron emission tomography (PET) offers a valuable tool for diagnosing myocardial ischemia and microvascular dysfunction, especially when other methods fail.
  • This technique can refine the diagnosis and management of myocardial infarction with non-obstructive coronary arteries (MINOCA).